PMS and PMDD: Do You Suffer from Premenstrual Syndrome or Premenstrual Dysphoric Disorder?

Premenstrual Syndrome (PMS) and PMDD (Premenstrual Dysphoric Disorder) – Toronto Naturopath

You live with PMS symptoms because you are a strong, stoic woman, but PMS does not have to be a fact of life every month. Premenstrual syndrome (PMS) affects 75–90% of women at some point, making it extremely common, but common is not the same as normal. Recurring premenstrual symptoms are a signal that something in your hormonal environment is off balance and worth investigating.

As a Toronto naturopath with a focus on women’s hormonal health, my approach to PMS and PMDD is not to suppress symptoms; it is to identify and correct the underlying drivers: progesterone deficiency, estrogen dominance, impaired neurotransmitter synthesis or utilization, nutrient depletion, or some combination of all four.

PMS vs. PMDD – Understanding the Diagnostic Distinction

PMS and PMDD (Premenstrual Dysphoric Disorder) exist on a continuum of the same hormonal disruption, but they differ significantly in severity and in the weight of psychiatric symptoms, and that distinction matters for how they are treated.

What Is PMS?

Premenstrual syndrome is defined as a pattern of physical and emotional symptoms that consistently appear during the luteal phase of the menstrual cycle (the two weeks before menstruation) and resolve within a few days of menstrual onset. By definition, there must be a symptom-free window of at least one week post-menstruation. Symptoms are recurrent and predictable, and they interfere meaningfully with daily function.

What Is PMDD, and How Is It Diagnosed?

PMDD is classified in the DSM-5 as a depressive disorder, not simply severe PMS. To meet diagnostic criteria, a patient must experience at least 5 symptoms during the luteal phase, including at least 1 from the core mood symptom cluster. Symptoms must be absent or minimal in the week following menstruation and must cause clinically significant functional impairment.¹

DSM-5 Core Mood Symptoms (at least one required):

• Marked affective lability (sudden tearfulness, mood swings, sensitivity to rejection)
• Marked irritability or anger, or increased interpersonal conflict
• Marked depressed mood, hopelessness, or self-deprecating thoughts
• Marked anxiety, tension, or feeling keyed up or on edge

Additional DSM-5 Symptoms (to total five or more):

• Decreased interest in usual activities
• Difficulty concentrating
• Lethargy or marked lack of energy
• Marked appetite change, food cravings, or overeating
• Hypersomnia or insomnia
• Feeling overwhelmed or out of control
• Physical symptoms: breast tenderness, bloating, joint or muscle pain, weight gain

Prospective daily symptom tracking across two consecutive menstrual cycles is required to confirm the luteal phase timing pattern. This is not a diagnosis that should be made retrospectively or on the basis of a single office visit.

PMS and PMDD Symptoms

Premenstrual syndrome symptoms may include the following:

• Acne
• Anxiety
• Backaches
• Bloated abdomen
• Breast pain
• Constipation
• Cramping
• Crying easily or crying spells
• Depression
• Difficulty concentrating
• Difficulty sleeping
• Emotional hypersensitivity
• Excessive hunger or overeating
• Feeling depressed, irritable or anxious
• Food cravings for things like sweets, salty or chocolate
• Forgetfulness
• Headaches or migraines
• Irritability
• Low energy
• Joint pains
• Low libido
• Mood swings
• Tender, swollen breasts
• Suicidal thoughts
• Water retention
• Weight gain
• Withdrawal

Why the Distinction Between PMS and PMDD Matters for Treatment

PMDD involves a significantly more pronounced dysregulation of the progesterone metabolite allopregnanolone on GABA-A receptors, and carries a higher risk of suicidal ideation during the luteal phase. It also responds differently to some interventions; certain supplements effective for PMS show a weaker effect size in confirmed PMDD. Knowing where a patient sits on this spectrum is essential before selecting a treatment approach.

If you are searching for a PMDD naturopath in Toronto, I want to be clear: PMDD requires thorough assessment, prospective symptom tracking, and, in some cases, co-management with a physician. I work collaboratively with patients and their medical team to ensure appropriate care.

The Progesterone Deficiency Connection

The most consistent hormonal finding in PMS and PMDD research is not simply “low progesterone” but rather an abnormal hormonal ratio and deficient production of progesterone’s active metabolite, allopregnanolone, during the luteal phase.³

Luteal Phase Length and Progesterone Timing

A normal luteal phase spans 12-14 days. A short luteal phase (fewer than 10 days) is a reliable marker of inadequate progesterone production and is one of the most common, and most underdiagnosed, findings in women with recurrent PMS. Progesterone is produced almost exclusively by the corpus luteum following ovulation. If ovulation is delayed, suppressed, or of poor quality, as frequently occurs under chronic stress, with thyroid dysfunction, or with hypothalamic suppression from under-eating, progesterone production will be insufficient regardless of what blood tests show in isolation.

Serum progesterone testing on day 21 of a 28-day cycle (or 7 days after confirmed ovulation) is the standard measure. An optimal peak luteal progesterone level is generally around 50-60 nmol/L, though functional ranges and symptom correlation must be interpreted in clinical context.

The Estrogen-to-Progesterone Ratio

Absolute progesterone levels are only part of the picture. When estrogen is elevated, through impaired liver clearance, xenoestrogen exposure, or excess adipose tissue aromatization, even normal progesterone levels may be insufficient to counterbalance estrogen’s proliferative effects. This relative estrogen dominance drives fluid retention, breast tenderness, mood instability, and heavy periods that many women attribute broadly to “hormones.”

Allopregnanolone and Neurosteroid Activity

Progesterone is converted in the brain and periphery to allopregnanolone, a potent positive allosteric modulator of GABA-A receptors. In women with PMS and PMDD, the sensitivity of GABA-A receptors to allopregnanolone appears to be abnormally reduced during the luteal phase, rather than allopregnanolone being absent.⁴ The luteal-phase rise in progesterone, and its subsequent fall before menstruation, triggers an adaptive response in GABA-A receptor subunit composition that may paradoxically increase anxiety rather than reduce it in susceptible women. This is a central mechanism in the pathophysiology of PMDD.

The Serotonin and GABA Connection – Why Low Progesterone Disrupts Mood

The hormone-to-neurotransmitter pathway in PMS is not metaphorical – it is biochemically direct, and it explains why premenstrual mood symptoms are not “all in your head.”

Progesterone, Allopregnanolone, and GABA-A

GABA (gamma-aminobutyric acid) is the brain’s primary inhibitory neurotransmitter. It produces calming, anxiolytic effects by binding to GABA-A receptors. Allopregnanolone enhances GABA-A receptor activity in a manner similar to benzodiazepines and barbiturates; this was demonstrated in the landmark Majewska et al. study published in Science.⁵ When progesterone falls sharply in the late luteal phase, allopregnanolone drops with it. In women with PMS, this withdrawal is experienced as a functional reduction in GABAergic inhibition, manifesting as anxiety, irritability, and sleep disruption. Women with PMDD show a paradoxical, worsened response to this same neurosteroid shift.

Progesterone and Serotonin Synthesis

Progesterone and its metabolites also influence serotonin availability through multiple pathways:

• Progesterone upregulates the expression of tryptophan hydroxylase, the rate-limiting enzyme in serotonin biosynthesis
• Estrogen dominance in the presence of low progesterone reduces MAO activity, transiently elevating and then crashing serotonin, which is why some women experience brief euphoria mid-cycle followed by abrupt mood deterioration
• B6 (pyridoxine) is the cofactor for the decarboxylation step in serotonin synthesis; B6 depletion, common with long-term oral contraceptive use and high-stress states, directly limits serotonin production regardless of progesterone status

The Oral Contraceptive Confound

Many women with PMS are placed on oral contraceptives to “regulate their hormones.” Combined OCs suppress endogenous progesterone production entirely and deplete B6, zinc, and magnesium, nutrients required for both serotonin synthesis and GABAergic function. This is why some women report worsening mood symptoms, including new-onset depression and anxiety, after starting OCs.

Lab Testing for PMS and PMDD – What a Naturopath Evaluates

Effective treatment begins with targeted testing. The following assessments help identify the specific hormonal and nutritional drivers in each patient.

Blood Tests

Blood tests on Day 2–3 of your menstrual cycle:

• FSH and LH (to assess ovarian function and rule out premature ovarian insufficiency or hypothalamic dysfunction)
• Estradiol (baseline follicular-phase estrogen)

Blood work on Day 21 of a 28-day cycle (or 7 days post-confirmed ovulation):

• Serum progesterone is the single most important PMS-related lab value. An optimal luteal peak is 50-60 nmol/L; levels below 40 nmol/L in the mid-luteal phase indicate inadequate corpus luteum function.

Any day of your cycle:

• DHEA-S (adrenal androgen status)
• Total testosterone and free testosterone (androgen-driven acne and mood symptoms)
• DHT (5-alpha reductase activity) can contribute to PMS/PMDD, hair loss, acne, and irregular cycles
• 8–9 a.m. cortisol (HPA axis function and stress hormone output)
• 25-OH Vitamin D (vitamin D is required for progesterone receptor sensitivity and hypothalamus function)
• Full thyroid panel: TSH, free T4, free T3, reverse T3, anti-TPO, anti-thyroglobulin (hypothyroidism and Hashimoto’s both impair luteal function and amplify PMS)
• Fasting glucose and insulin (to assess insulin resistance driving PMT-C)
• RBC magnesium (red blood cell magnesium is a more accurate reflection of intracellular stores)
• Serum B12 and folate

What a GP Typically Orders vs. What a Naturopath Tests for PMS

A standard GP assessment for PMS rarely extends beyond TSH and a basic hormone panel run at an arbitrary point in the cycle. By contrast, a naturopathic assessment targets cycle-day-specific testing, evaluates optimal, not just “normal” reference ranges, and considers the functional interplay between hormones, nutrients, and neurotransmitters. A peak serum progesterone of 10 nmol/L may be reported as “normal” by a lab, but it is functionally insufficient for symptom-free luteal phase function.

DUTCH Testing for PMS or PMDD

The DUTCH Complete (Dried Urine Test for Comprehensive Hormones) provides urinary hormone metabolites that serum panels cannot. For PMS and PMDD assessment, the DUTCH offers:

• Estrogen metabolite ratios (2-OH vs. 16-OH estrone) to assess liver estrogen clearance pathways
• Glucuronidated and sulphated progesterone metabolites
• Cortisol and cortisone diurnal pattern across four time points
• Androgen metabolites, including DHEA-S and androsterone
• Melatonin (as 6-OHMS) – relevant for sleep-disrupted PMS-D presentations

DUTCH Cycle Mapping is available for patients with complex or ambiguous cycle presentations: it involves testing across 11 days of the menstrual cycle to map the progesterone and estrogen curves in real time, providing precision that no single mid-luteal blood draw (a one-second snapshot) can match.

OAT Testing

The Organic Acids Test provides functional markers of neurotransmitter metabolism, including quinolinic acid (tryptophan-serotonin pathway), homovanillic acid and vanillylmandelic acid (dopamine and norepinephrine), as well as markers of mitochondrial function, B vitamin status, and yeast/bacterial dysbiosis. It is particularly useful in PMT-A and PMT-D presentations where mood symptoms dominate.

Basal Body Temperature Charting

BBT charting over two to three consecutive cycles documents whether ovulation is occurring, when it occurs relative to the cycle length, and the length of the luteal phase. A sustained post-ovulatory temperature rise lasting fewer than 10 days is consistent with a short luteal phase and inadequate progesterone production. This is low-cost, non-invasive, and clinically informative, particularly when timed blood tests are not feasible.

Naturopathic Treatment of Premenstrual Syndrome (PMS) and PMDD

Address the root cause of the problem; don’t settle for just easing the symptoms. PMS is caused by nutrient deficiencies, blood sugar instability, hormonal imbalances, and/or hormone fluctuations throughout a woman’s menstrual cycle.

Evidence-Based Natural Treatment for PMS and PMDD

The goal is not symptom management. It is identifying and correcting the mechanisms driving your symptoms. The following interventions are supported by clinical evidence.

Vitamin B6 (Pyridoxine or P5P)

B6 is the cofactor for the final enzymatic step in serotonin synthesis (conversion of 5-HTP to serotonin via aromatic L-amino acid decarboxylase) and plays a parallel role in dopamine synthesis. It is also required for hepatic estrogen metabolism. A systematic review of 940 patients across nine randomized controlled trials found that B6 supplementation at doses up to 100 mg/day was more likely to relieve overall premenstrual and depressive symptoms than placebo.⁶ B6 depletion is common in women using hormonal contraceptives and under high chronic stress.

Magnesium

Magnesium is involved in over 300 enzymatic reactions, including those governing serotonin synthesis, aldosterone regulation, prostaglandin E1 production, and glucose transport. Magnesium deficiency is documented disproportionately in women with PMS relative to symptom-free controls.

Clinical evidence supports magnesium supplementation specifically for:

Fluid retention and bloating (PMT-H): A randomized trial by Walker et al. found that 200 mg magnesium daily reduced weight gain, swelling, abdominal bloating, and breast tenderness in women with PMS.⁷

Anxiety symptoms (PMT-A): De Souza et al. found that combined magnesium (200 mg) and B6 (50 mg) supplementation significantly reduced anxiety-related premenstrual symptoms compared to either nutrient alone.⁸

Magnesium glycinate is the preferred form for most patients. It’s well-absorbed and less likely to cause the laxative effect associated with magnesium oxide or citrate at higher doses.

Vitex Agnus-Castus (Chaste Tree Berry)

Vitex acts primarily on the hypothalamic-pituitary axis. Its active compounds bind to dopamine D2 receptors in the pituitary gland, thereby suppressing excess prolactin secretion. Elevated prolactin inhibits progesterone production from the corpus luteum, reducing prolactin can, indirectly, support luteal progesterone output and lengthen the luteal phase. Vitex also has mild agonist activity at mu-opioid receptors, which may contribute to its mood-stabilizing and pain-reducing effects.

A randomized, placebo-controlled trial by Schellenberg et al. demonstrated that standardized Vitex extract reduced overall PMS symptom severity by 52% versus 24% with placebo, with particularly strong effects on irritability, mood change, anger, headache, and breast fullness.⁹ Vitex is not appropriate in all clinical contexts; it is contraindicated with dopaminergic medications and should not be self-prescribed. In women with PCOS and high LH, it may further increase testosterone. Formulation, standardization, and dose selection matter considerably.

Calcium

Calcium has one of the strongest evidence bases of any supplement studied in PMS. A large randomized controlled trial by Thys-Jacobs et al., 497 women across 12 U.S. sites, found that 1,200 mg/day of calcium carbonate over three cycles reduced total PMS symptom scores by 48% compared to 30% with placebo.¹⁰ Calcium supplementation was effective across all four symptom factors studied: negative affect, water retention, food cravings, and pain. The mechanism appears to involve calcium’s role in regulating parathyroid hormone and vitamin D signalling, both of which fluctuate across the menstrual cycle and influence mood and muscle function.

Lifestyle and Dietary Foundation

No supplement protocol replaces the dietary and lifestyle fundamentals:

Blood sugar stability: Luteal-phase insulin sensitivity fluctuates, and reactive hypoglycemia worsens mood instability, cravings, and fatigue. A low-glycemic index diet with adequate protein at every meal, chromium supplementation where indicated, and regular physical activity are foundational, not adjunctive.

Xenoestrogen reduction: Phthalates, bisphenol A, and other endocrine-disrupting chemicals found in plastics, personal care products, and conventionally produced animal fats competitively bind estrogen receptors and impair liver estrogen clearance. Reducing exposure, choosing glass storage, choosing organic animal products, and using clean personal care formulations reduce the total estrogenic load on your system.

Liver detoxification support: Estrogen is cleared through Phase I (CYP450-mediated hydroxylation) and Phase II (glucuronidation, sulfation, methylation) pathways. Cruciferous vegetables supply indole-3-carbinol and DIM, which favour 2-hydroxylation over the more proliferative 16-alpha hydroxylation pathway. B vitamins, methionine, and magnesium support Phase II methylation. Poor liver clearance leads to estrogen recirculation, a primary driver of estrogen dominance in women who are not producing excess estrogen but cannot clear it efficiently.

Exercise: Moderate aerobic exercise in the follicular phase supports dopamine and serotonin production. Women with PMS who engage in consistent physical activity across the cycle show attenuated luteal-phase mood symptoms compared to sedentary controls.

Frequently Asked Questions About PMS and PMDD

What is the difference between PMS and PMDD?

PMS involves physical and mood symptoms in the two weeks before your period that resolve with menstruation. PMDD is a DSM-5 classified condition defined by more severe, predominantly mood-based symptoms, including marked depression, severe anxiety, or anger, that cause significant functional impairment. PMDD requires at least five symptoms during the luteal phase with at least one being a core mood symptom, confirmed prospectively over two consecutive cycles. PMDD is not simply “bad PMS”; it involves a distinct neurosteroid sensitivity pattern and may require a different clinical approach, including potential co-management with a physician.

Can a naturopath help with PMDD?

Yes. A naturopath can conduct a thorough hormonal and nutritional assessment, identify the underlying drivers, including progesterone insufficiency, estrogen dominance, B6 depletion, and serotonin pathway dysfunction, and develop an individualized evidence-based treatment plan. For moderate to severe PMDD, naturopathic care is often most effective when integrated with medical management. If you are in Toronto and looking for a naturopath experienced in PMDD, I encourage you to book a consultation to determine whether naturopathic treatment is appropriate for your specific presentation.

What causes PMS?

PMS is not caused by a single factor. The most common underlying drivers include: relative progesterone deficiency or a short luteal phase; estrogen dominance from impaired liver clearance or xenoestrogen exposure; deficiencies in magnesium, B6, calcium, or essential fatty acids; blood sugar dysregulation; HPA axis dysfunction with elevated cortisol; and impaired serotonin synthesis. Identifying the specific combination driving your symptoms is what makes targeted treatment possible.

What lab tests should I have done for PMS?

At minimum: serum progesterone on day 21 of your cycle (or ideally 7 days post confirmed ovulation), day 2–3 FSH/LH/estradiol, TSH with free T3 and free T4, fasting insulin and glucose, vitamin D, B12, and magnesium. DUTCH Complete testing provides a more comprehensive view of estrogen and progesterone metabolism and cortisol patterns. DUTCH Cycle Mapping is indicated when the presentation is complex or when standard serum testing has been unrevealing. These tests help distinguish between the causes of PMS rather than simply confirming its presence.

How long does it take to see improvement in PMS with naturopathic treatment?

Most patients notice meaningful improvement within two to three menstrual cycles with consistent implementation of a targeted protocol. Nutrient-based interventions, B6, magnesium, and calcium, tend to produce noticeable effects within one to two cycles. Vitex requires three to six months of consistent use to fully express its clinical effect, as it acts at the level of the hypothalamic-pituitary axis rather than providing immediate hormonal replacement. The time it takes to see results correlates with how long the underlying imbalances have been present and with whether the root cause, not just symptoms, is being addressed.

Is it normal to have PMS every month?

Common is not the same as normal. PMS affects the majority of women at some point, but its recurrence signals an underlying hormonal or nutritional imbalance that is correctable. Accepting monthly PMS as an inevitable feature of being female means living with a preventable reduction in quality of life for approximately one-quarter of every month.

Can dietary changes alone resolve PMS?

For mild PMS, dietary changes, including reducing refined sugars, sodium, and alcohol in the luteal phase, stabilizing blood sugar, and increasing magnesium-rich whole foods, can produce significant improvement. For moderate-to-severe PMS and PMDD, dietary changes are foundational but rarely sufficient in isolation. Targeted supplementation, hormonal assessment, and liver detoxification support are generally required to produce a durable resolution.

Book a PMS or PMDD Consultation in Toronto

If you are dealing with predictable monthly symptoms that your GP has attributed simply to “hormones” without further investigation, a comprehensive naturopathic assessment can identify exactly which hormonal and nutritional mechanisms are driving your experience, and what to do about them.

Dr. Pamela Frank, ND, has been working with women’s hormonal health in Toronto for 26 years. Her approach combines thorough clinical investigation, evidence-based supplementation, and targeted lifestyle medicine to address PMS and PMDD at the root level.

Consultations are available in person at 568 St. Clair Ave W, Toronto, and via virtual appointment for anyone anywhere in Ontario, Canada.

Book an appointment here or call the clinic for more information at 416-481-0222.

PMS & PMDD Natural Treatment Research

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Publishing; 2013:171-175.
2. Abraham GE. Nutritional factors in the etiology of the premenstrual tension syndromes. J Reprod Med. 1983 Jul;28(7):446-64. PMID: 6684167.
3. Bixo M, Ekberg K, Poromaa IS, Hirschberg AL, Jonasson AF, Andréen L, Timby E, Wulff M, Ehrenborg A, Bäckström T. Treatment of premenstrual dysphoric disorder with the GABA_A receptor modulating steroid antagonist Sepranolone (UC1010)-A randomized controlled trial. Psychoneuroendocrinology. 2017 Jun;80:46-55. doi: 10.1016/j.psyneuen.2017.02.031. Epub 2017 Mar 1. PMID: 28319848.
4. Bäckström T, Andersson A, Andreé L, Birzniece V, Bixo M, Björn I, Haage D, Isaksson M, Johansson IM, Lindblad C, Lundgren P, Nyberg S, Odmark IS, Strömberg J, Sundström-Poromaa I, Turkmen S, Wahlström G, Wang M, Wihlbäck AC, Zhu D, Zingmark E. Pathogenesis in menstrual cycle-linked CNS disorders. Ann N Y Acad Sci. 2003 Dec;1007:42-53. doi: 10.1196/annals. 1286.005. PMID: 14993039.
5. Majewska MD, Harrison NL, Schwartz RD, Barker JL, Paul SM. Steroid hormone metabolites are barbiturate-like modulators of the GABA receptor. Science. 1986 May 23;232(4753):1004-7. doi: 10.1126/science.2422758. PMID: 2422758.
6. Wyatt KM, Dimmock PW, Jones PW, Shaughn O’Brien PM. Efficacy of vitamin B-6 in the treatment of premenstrual syndrome: systematic review. BMJ. 1999 May 22;318(7195):1375-81. doi: 10.1136/bmj.318.7195.1375. PMID: 10334745; PMCID: PMC27878.
7. Walker AF, De Souza MC, Vickers MF, Abeyasekera S, Collins ML, Trinca LA. Magnesium supplementation alleviates premenstrual symptoms of fluid retention. J Womens Health. 1998 Nov;7(9):1157-65. doi: 10.1089/jwh.1998.7.1157. PMID: 9861593.
8. De Souza MC, Walker AF, Robinson PA, Bolland K. A synergistic effect of a daily supplement for 1 month of 200 mg magnesium plus 50 mg vitamin B6 for the relief of anxiety-related premenstrual symptoms: a randomized, double-blind, crossover study. J Womens Health Gend Based Med. 2000;9(2):131-139. PMID: 10746516
9. Schellenberg R. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomized, placebo-controlled study. BMJ. 2001 Jan 20;322(7279):134-7. doi: 10.1136/bmj.322.7279.134. PMID: 11159568; PMCID: PMC26589.
10. Thys-Jacobs S, Starkey P, Bernstein D, Tian J. Calcium carbonate and the premenstrual syndrome: effects on premenstrual and menstrual symptoms. Premenstrual Syndrome Study Group. Am J Obstet Gynecol. 1998 Aug;179(2):444-52. doi: 10.1016/s0002-9378(98)70377-1. PMID: 9731851.

Curcumin:

Khayat S, Fanaei H, Kheirkhan M, Moghadam Z, Kasaeian A, Javadimehr M. Curcumin attenuates the severity of premenstrual syndrome symptoms: a randomized, double-blind, placebo-controlled trial. Complement Ther Med. 2015: 23(3):318-24.

Aerobic Exercise:

Samadi Z, Taghian F, Valiani M. The effects of 8 weeks of regular aerobic exercise on the symptoms of premenstrual syndrome in non-athlete girls. Iran J Nurs Midwifery Res. 2013; 18(1):14-9.
● After 8 weeks of aerobic training (three 60-min sessions per week), mean scores of PMS and symptoms declined significantly

Vitex agnus castus:

Vitex agnus castus extract in women with premenstrual syndrome was found to decrease symptom severity.
Source: Phytomedicine. 2012 Nov 15;19(14):1325-31. Epub 2012 Sep 28.

Vitex agnus castus extract was found to be an effective and well-tolerated treatment for the relief of mild to moderate PMS symptoms.
Source: Acta Med Iran. 2012;50(2):101-6.

In 7/8 trials with premenstrual syndrome patients, Vitex extracts were found to be superior to placebo, pyridoxine, and magnesium oxide at dealing with the symptoms.
Source: Planta Med. 2012 Nov 7.

In a systematic review, V. angus castus (common name: chastetree), was proven to be a safe and effective treatment for PMS and premenstrual dysphoric disorder (#PMDD).
Source: Vitex agnus castus for premenstrual syndrome and premenstrual dysphoric disorder: a systematic review. Arch Womens Ment Health. 2017 Dec;20(6):713-719.

Evening Primrose Oil:

Current evidence suggests that oral evening primrose oil is likely ineffective for the treatment of premenstrual syndrome.
Source: American Family Physician, Volume 80, Issue 12, pages 1405-1408, December 2009.

Magnesium:

A study found that supplementation with magnesium and vitamin B6 led to the greatest decrease in PMS symptoms.
Source: Iranian Journal of Nursing and Midwifery Research, Volume 15, Issue 1, pages 401-405, December 2010.

Omega-3s:

Taking a daily omega-3 supplement led to a reduction in PMS symptoms including decreased severity and duration of depression, anxiety, lack of concentration and bloating.
Source: Complementary Therapies in Medicine Jan 2013 (In press).

Supplementation with omega-3 fatty acids was found to decrease the severity of depression, anxiety, lack of concentration and bloating in individuals with PMS. Source: Complement Ther Med. 2013 Jun;21(3):141-6

Zinc:

Low dietary intake of zinc has been identified as a possible risk factor for the development of PMS.
Source: Am. J. Epidemiol. (2013) doi: 10.1093/aje/kws363

Iron:

Low dietary intake of iron has been identified as a possible risk factor for the development of PMS.
Source: Am. J. Epidemiol. (2013) doi: 10.1093/aje/kws363

Chamomile:

Supplementation with chamomile extract was found to be more effective at reducing the intensity of emotional symptoms of premenstrual syndrome than mefenamic acid.  Source: Complementary Therapies in Clinical Practice October 2013

Dr. Pamela Frank has been in practice as a naturopathic doctor for over 26 years. Since 1999, she has earned acclaim as a leading naturopath in Toronto, amassing multiple awards.

Dr. Pamela has a special interest in addressing hormone-related complexities, including but not limited to PCOS, endometriosis, acne, hair loss, weight management, thyroid issues, and fertility.

Residing in Toronto with her family and loyal companion, Dolly the rescue dog, Dr. Pamela seamlessly combines her professional commitment with a diverse range of interests.

Beyond her clinical endeavours, she actively engages in kickboxing, leadership roles within Scout Groups, yoga practice, podcasting, and outdoor pursuits such as backcountry camping.

Dr. Pamela’s comprehensive approach reflects not only her dedication to optimal health but also her passion for continual personal and professional growth.

DISCLAIMER: The information provided here may not apply precisely to your individual situation. Diagnostic and therapeutic choices must always be tailored to the individual patient’s circumstances, and consultation with a licensed naturopathic physician should be undertaken before following any of the treatment strategies suggested in this web site.